PDF(Pubmed)
Abstract：
BACKGROUND: Falls in older patients can lead to serious health complications and increased health care costs. Fall risk-increasing drugs (FRIDs) are a group of drugs that may induce falls or increase the tendency to fall (ie, fall risk). Deprescribing is the process of withdrawal from an inappropriate medication, supervised by a health care professional, with the goal of managing polypharmacy and improving outcomes.
OBJECTIVE: This study aims to assess the effectiveness of a deprescribing intervention based on the Assess, Review, Minimize, Optimize, and Reassess (ARMOR) tool in reducing the risk of falls in older patients and evaluate the cost-effectiveness of deprescribing FRIDs.
METHODS: This is an open-label, parallel-group randomized controlled academic trial. Individuals aged 60-80 years who are currently taking 5 or more prescribed drugs, including at least 1 FRID, will be recruited. Demographic data, medical conditions, medication lists, orthostatic hypotension, and fall history details will be collected. Fall concern will be assessed using the Fall Efficacy Scale, and fall risk will be assessed by the Timed Up and Go test and Tinetti Performance-Oriented Mobility Assessment tool. In this study, all treating physicians will be randomized using a stratified randomization method based on seniority. Randomized physicians will do deprescribing with the ARMOR tool for patients on FRIDs. Participants will maintain diaries, and monthly phone follow-ups will be undertaken to monitor falls and adverse events. Physical assessments will be performed to evaluate fall risk every 3 months for a year. The rationality of prescription drugs will be evaluated using the World Health Organization\'s core indicators.
RESULTS: The study received a grant from the Indian Council of Medical Research-Safe and Rational Use of Medicine in October 2023. The study is scheduled to commence in April 2024 and conclude by 2026. Efficacy will be measured by fall frequency and changes in fall risk scores. Cost-effectiveness analysis will also include the incremental cost-effectiveness ratio calculation. Adverse events related to deprescription will be recorded.
CONCLUSIONS: This trial will provide essential insights into the efficacy of the ARMOR tool in reducing falls among the geriatric population who are taking FRIDs. Additionally, it will provide valuable information on the cost-effectiveness of deprescribing practices, offering significant implications for improving the well-being of older patients and optimizing health care resource allocation. The findings from this study will be pertinent for health care professionals, policy makers, and researchers focused on geriatric care and fall prevention strategies.
BACKGROUND: Clinical Trials Registry - India CTRI/2023/12/060516; https://ctri.nic.in/Clinicaltrials/pubview2.php.
UNASSIGNED: PRR1-10.2196/55638.
OBJECTIVE: This study aims to assess the effectiveness of a deprescribing intervention based on the Assess, Review, Minimize, Optimize, and Reassess (ARMOR) tool in reducing the risk of falls in older patients and evaluate the cost-effectiveness of deprescribing FRIDs.
METHODS: This is an open-label, parallel-group randomized controlled academic trial. Individuals aged 60-80 years who are currently taking 5 or more prescribed drugs, including at least 1 FRID, will be recruited. Demographic data, medical conditions, medication lists, orthostatic hypotension, and fall history details will be collected. Fall concern will be assessed using the Fall Efficacy Scale, and fall risk will be assessed by the Timed Up and Go test and Tinetti Performance-Oriented Mobility Assessment tool. In this study, all treating physicians will be randomized using a stratified randomization method based on seniority. Randomized physicians will do deprescribing with the ARMOR tool for patients on FRIDs. Participants will maintain diaries, and monthly phone follow-ups will be undertaken to monitor falls and adverse events. Physical assessments will be performed to evaluate fall risk every 3 months for a year. The rationality of prescription drugs will be evaluated using the World Health Organization\'s core indicators.
RESULTS: The study received a grant from the Indian Council of Medical Research-Safe and Rational Use of Medicine in October 2023. The study is scheduled to commence in April 2024 and conclude by 2026. Efficacy will be measured by fall frequency and changes in fall risk scores. Cost-effectiveness analysis will also include the incremental cost-effectiveness ratio calculation. Adverse events related to deprescription will be recorded.
CONCLUSIONS: This trial will provide essential insights into the efficacy of the ARMOR tool in reducing falls among the geriatric population who are taking FRIDs. Additionally, it will provide valuable information on the cost-effectiveness of deprescribing practices, offering significant implications for improving the well-being of older patients and optimizing health care resource allocation. The findings from this study will be pertinent for health care professionals, policy makers, and researchers focused on geriatric care and fall prevention strategies.
BACKGROUND: Clinical Trials Registry - India CTRI/2023/12/060516; https://ctri.nic.in/Clinicaltrials/pubview2.php.
UNASSIGNED: PRR1-10.2196/55638.
摘要：
背景：老年患者的跌倒可导致严重的健康并发症和增加的医疗保健费用。跌倒风险增加药物（FRID）是一组可能诱发跌倒或增加跌倒倾向的药物（即，跌倒风险)。开药是指从不适当的药物中撤出的过程，在医疗保健专业人员的监督下，以管理多重药房和改善结果为目标。
目的：本研究旨在根据评估结果评估去处方干预的有效性。Review,最小化,优化,和重新评估(ARMOR)工具在降低老年患者跌倒风险方面的作用,并评估取消FRIDs处方的成本-效果。
方法：这是一个开放标签，平行组随机对照学术试验。目前正在服用5种或更多处方药的60-80岁个人，包括至少1个FRID，将被招募。人口统计数据,医疗条件,药物清单,直立性低血压,和秋季历史细节将被收集。跌倒关注将使用跌倒功效量表进行评估，和跌倒风险将通过定时UpandGo测试和Tinetti以性能为导向的移动性评估工具进行评估。在这项研究中,所有主治医师将采用基于资历的分层随机化方法进行随机化.随机医师将使用ARMOR工具对FRID患者进行处方。参与者将保持日记，每月进行电话随访，以监测跌倒和不良事件。将进行身体评估，以评估跌倒风险每3个月一年。使用世界卫生组织的核心指标对处方药的合理性进行评价。
结果：该研究于2023年10月获得了印度医学研究理事会的资助-安全和合理使用药物。该研究计划于2024年4月开始，并于2026年结束。将通过跌倒频率和跌倒风险评分的变化来衡量功效。成本效益分析还将包括增量成本效益比计算。将记录与取消处方相关的不良事件。
结论：该试验将为ARMOR工具在减少服用FRIDs的老年人群跌倒方面的有效性提供重要见解。此外,它将提供有关取消处方做法的成本效益的宝贵信息，对改善老年患者的福祉和优化医疗资源分配具有重要意义。这项研究的结果将与医疗保健专业人员有关，政策制定者,研究人员专注于老年护理和跌倒预防策略。
背景：临床试验注册-印度CTRI/2023/12/060516;https://ctri。nic.在/临床试验/pubview2。php。
■PRR1-10.2196/55638。
目的：本研究旨在根据评估结果评估去处方干预的有效性。Review,最小化,优化,和重新评估(ARMOR)工具在降低老年患者跌倒风险方面的作用,并评估取消FRIDs处方的成本-效果。
方法：这是一个开放标签，平行组随机对照学术试验。目前正在服用5种或更多处方药的60-80岁个人，包括至少1个FRID，将被招募。人口统计数据,医疗条件,药物清单,直立性低血压,和秋季历史细节将被收集。跌倒关注将使用跌倒功效量表进行评估，和跌倒风险将通过定时UpandGo测试和Tinetti以性能为导向的移动性评估工具进行评估。在这项研究中,所有主治医师将采用基于资历的分层随机化方法进行随机化.随机医师将使用ARMOR工具对FRID患者进行处方。参与者将保持日记，每月进行电话随访，以监测跌倒和不良事件。将进行身体评估，以评估跌倒风险每3个月一年。使用世界卫生组织的核心指标对处方药的合理性进行评价。
结果：该研究于2023年10月获得了印度医学研究理事会的资助-安全和合理使用药物。该研究计划于2024年4月开始，并于2026年结束。将通过跌倒频率和跌倒风险评分的变化来衡量功效。成本效益分析还将包括增量成本效益比计算。将记录与取消处方相关的不良事件。
结论：该试验将为ARMOR工具在减少服用FRIDs的老年人群跌倒方面的有效性提供重要见解。此外,它将提供有关取消处方做法的成本效益的宝贵信息，对改善老年患者的福祉和优化医疗资源分配具有重要意义。这项研究的结果将与医疗保健专业人员有关，政策制定者,研究人员专注于老年护理和跌倒预防策略。
背景：临床试验注册-印度CTRI/2023/12/060516;https://ctri。nic.在/临床试验/pubview2。php。
■PRR1-10.2196/55638。
